Evaluation and Management of Thoracolumbar Spine Trauma in Pediatric Patients: A Critical Analysis Review.

JBJS Rev · Jun 01 2024 · Review

Bonsignore-Opp L, O'Donnell J, Agha O, Bach K, Metz L, Swarup I

Department of Orthopedic Surgery, University of California San Francisco, San Francisco

Spine Pediatric Orthopaedics

SUMMARY — THE REDUCTIONThis review highlights that pediatric thoracolumbar spine trauma requires a low threshold for MRI and that management decisions should be guided mainly by injury pattern and neurologic status, given limited pediatric-specific evidence.
Abstract, as published

» Pediatric thoracolumbar trauma, though rare, is an important cause of morbidity and mortality and necessitates early, accurate diagnosis and management.» Obtaining a detailed history and physical examination in the pediatric population can be difficult. Therefore, the threshold for advanced imaging, such as magnetic resonance imaging, is low and should be performed in patients with head injuries, altered mental status, inability to cooperate with examination, and fractures involving more than 1 column of the spine.» The classification of pediatric thoracolumbar trauma is based primarily on adult studies and there is little high-level evidence examining validity and accuracy in pediatric populations.» Injury pattern and neurologic status of the patient are the most important factors when determining whether to proceed with operative management.

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